The Mask of Sanity. Hervey M. Cleckley

he could command. These influences, he very truly pointed out, had lent themselves to his efforts to get out of jail and out of hospitals in the past. He insisted, furthermore, that certain other attendants whom he disliked be discharged. Storming and cursing and threatening, he was removed to a closed ward.

      Somewhat disgruntled, he ceased his modeling in postprandial bread and sulked, irritable and aggressive, among his psychotic companions. Soon, however, he became more agreeable and after a few days came swaggering into my office to display a new product of his ingenuity. Borrowing a dollar bill and a pair of scissors, he cut out five rectangles of plain paper identical in size and shape with the bill and poised himself with a faintly prestidigitatorial air.

      “Watch this,” he boasted.

      As he cut up his models of the bank note and manipulated the pieces, he called for paste to be brought. Then, after a shrewd and tricky rearrangement, he pasted together his fragments.

      “Count them,” he ordered in the grand manner.

      Not five but six paper models lay on the table, all plainly patched, but all defying the ordinary eye to detect any appreciable loss of substance.

      Within a week his wife, after haunting the hospital and begging for his parole, insisting that she needed him at home, that she was in want, etc., succeeded in taking him out in her custody. Late that night local policemen brought him back. After giving his wife what might be called an average beating, he had caused considerable uproar at the bawdy house and fled to another dive where, after trying to get loans from a few idlers, he boasted and quarreled until the police intervened.

      He remained then on a closed ward for about a week when, legal charges against him having been dropped, he demanded release against medical advice. Since he was sane and competent in the eyes of law and science, he was discharged.

      Two months later local newspapers carried small headlines calling attention to his being taken by federal agents after a protracted investigation in Texas. For weeks patched-up five, ten, and twenty dollar bills circulated in several Texas cities, and Max, decked in flashy finery, drove about in his own car and splurged lavishly on food, drink, and women. The surprising volume of mutilated notes at last caused comment and finally suspicion. After skillful and persistent efforts, the federal agents finally worked out the puzzle and brought it to Max’s feet.

      My colleagues and I felt that perhaps our acquaintance with Max had ended. Federal justice is widely regarded as less relenting and less distractible than municipal and state justice. For most lawbreakers this is, indeed, true. Max’s old play, however, had not lost its charm. Some months later he was in a psychiatric hospital and shortly afterward at large.

      His career continued. The records show that once, while under a five-year sentence to a state penitentiary, he stressed his former syphilitic infection and boasted so vehemently in his old style that a physician who saw him in prison made a diagnosis of dementia paralytica. No neurologic or serologic findings supported this opinion, which was offered by a general practitioner after one interview. This was enough to start the familiar cycle of prison-to hospital-to-freedom.

      Once again, when anxious for shelter, he boasted that he could communicate with ancestors who had died thousands of years ago. His wife joined in and claimed that he had seen monkeys and baboons chasing him. At a general hospital a tentative diagnosis of schizophrenia was offered. Back at another psychiatric hospital he showed no evidence of an orthodox psychosis and after a short time got his discharge.

      Again when pressed by a court verdict, he claimed amnesia for a period of two years, during which he had been active at defrauding. A suspicion of hysteria was expressed by some physicians. At the psychiatric hospital he stuck for a while to this story of amnesia but, his vanity being aroused, he recalled in detail all his experiences. It was plain from his manner that he had not suffered from any true amnesia, and he no longer took pains to make any one believe that he had.

      A few years later, he was brought to the hospital. This time his wife insisted that his beatings were too much to bear and stated that he had threatened to kill her with an axe, explaining that he could do so with impunity since he was a mentally disabled veteran and that, as she well knew, he had always succeeded in escaping the consequences of any crime. She soon recovered from her fears and asked for his parole. At the insistence of both man and wife, he was discharged after a few weeks.

      Be it noted that despite his vigorous threats such as the one just mentioned, Max seldom, if ever tried to do anyone serious physical injury. This fact has especial weight in view of his boasted and pretty satisfactorily demonstrated immunity from penal consequences. Max is not by inclination and has never been a violent or murderous person but in his conflicts with the law has appeared usually in the role of petty bully, sharper, thief, and braggart.

      Some months later I, with other psychiatrists, testified at court when efforts were being made to have Max committed by law as “insane.” Several citizens whom he had defrauded and seriously troubled in other ways, finding that he was not vulnerable to fines or sentences in the municipal courts, hoped to obtain relief and protection by getting him into a psychiatric hospital.

      The psychiatrists could not avoid admitting that he did not show evidence of anything that is officially classed as a psychosis. I had to agree. In trying to explain briefly and comprehensibly that I believed this man, while not suffering from a psychosis that could be named, or any of the technical symptoms of one, was entirely unsuited to be at large, the sense of futility was oppressive. Max, neat and well-groomed, insouciant, witty, alert and splendidly rational, rose, beaming, to hear again the verdict of freedom.

      CHAPTER 6. ROBERTA

      This young woman, sitting now for the first time in my office, gave an impression that vaguely suggested—immaturity? The word is not entirely accurate for the impression. Immaturity might imply the guarded, withdrawn attitude often shown by children in the doctor’s office. It was another, in fact, almost an opposite feeling that she gave. Something less than the average of self-consciousness, a sort of easy security that does not arise from effort or from pretense—some qualities of this nature seemed to enter into the impression.

      Roberta was just twenty years old, well-developed, a little overweight perhaps but not greatly overweight. It was, as one noticed more closely, a slight carelessness about dress, a laxness of posture more than any real obesity, that suggested an overnourished body. She was not pretty but her looks were pleasant. Unlike most girls of twenty she did not seem, with or without awareness, to be deliberately counting her feminine attractions into the equation that probably occurs in every personal contact between man and woman. This, perhaps, was what gave that first vague and complicated impression of an adult who, in some rather pleasant way, is still childlike.

      It was a little surprising to hear her admit that she had resented being brought for the interview because she felt her mother and father were overdoing things to try to find something “wrong with her mind.” There was nothing sullen about her and she soon expressed satisfaction at having come and a willingness to stay in the hospital as long as it might be deemed advisable.

      She admitted without reluctance that she needed help of some sort and that she had “made a mess” of her life. She expressed interest in plans for a different future. In speaking of her need for psychiatric treatment, something suggested that her conviction of need was more like what a man feels who looks in the mirror and decides he needs a haircut than the earnest and sometimes desperate need many people feel in their problems. The man who finds he needs the haircut is sincere in his conviction, despite the fact that about such a trivial matter convictions are also, and necessarily, trivial.

      In this interview and during subsequent weeks Roberta discussed in detail and at length hundreds of incidents in her life. Her history had been obtained from her parents, who accompanied her, and additional material was available in letters from her former girl scout leader, her Sunday School teacher, and others.

      “I can’t understand the girl, no matter how hard I try,” said the father, shaking his head in genuine perplexity. “It’s not that she seems bad or exactly that she means to do wrong. She can lie